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[Ascites].

S Stevan1, W Vetter, J Lukaschek

  • 1Medizinische Poliklinik, Departement für Innere Medizin, Universitätsklinik Zürich.

Praxis
|December 11, 1999
PubMed
Summary

Tuberculosis can mimic spontaneous bacterial peritonitis in patients with liver cirrhosis, leading to delayed diagnosis and treatment. Early identification of Mycobacterium tuberculosis is crucial for effective management of co-existing liver disease and tuberculosis.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Pulmonology

Background:

  • Liver cirrhosis frequently presents with ascites, increasing susceptibility to infections like spontaneous bacterial peritonitis.
  • Accurate diagnosis of ascites etiology is critical for appropriate patient management.

Observation:

  • A 53-year-old patient with alcoholic cirrhosis experienced recurrent ascites, fever, and abdominal pain, initially suspected as spontaneous bacterial peritonitis.
  • Standard antibiotic treatment for peritonitis was ineffective, prompting further investigation.

Findings:

  • Ascitic fluid and sputum analysis revealed Mycobacterium tuberculosis.
  • The patient was diagnosed with concurrent pulmonary and peritoneal tuberculosis.

Implications:

  • Tuberculosis should be considered in the differential diagnosis of ascites in cirrhotic patients, especially when peritonitis symptoms are unresponsive to antibiotics.
  • Tailored anti-tuberculosis therapy is essential, considering potential hepatic and renal impairment in these patients.

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